Today, we’re taking a closer look at Advanced Life Support (ALS) response. Sent to an incident by 911 dispatchers, ALS personnel, better known as paramedics, are sent to scenes where more intensive medical care is required, such as a heart attack or substantial physical trauma. Emergency Medical Technicians may have already reached the scene, providing initial support until paramedic units arrive.

We talked with Matt Riesenberg, Chief of Operations at King County Medic One, to learn more about his work as a paramedic.

Paramedic Matt Riesenberg with his daughter

How did you get involved in Emergency Medical Services?

I got my start in EMS by becoming a volunteer Emergency Medical Technician (EMT) on the campus where I attended college in 1998. I also worked in several hospitals as an emergency room technician, volunteered with a local fire department, and worked as an EMT with a private ambulance company. King County Medic One hired me in 2005, and I worked in the field as a paramedic for ten years, until I was promoted to a leadership position in 2015, and became our Chief of Operations in February of this year.

King County is known for having world-class survival rates for cardiac arrest. What’s your role in contributing to this success?

My job as the King County Medic One Chief of Operations is to make sure that the paramedics have the life-saving equipment and infrastructure that they require to do their amazing work. This includes writing policies, improving processes, paying bills, and dealing with any issues that arise.

As you’re heading toward a new patient, what does a dispatcher tell you before you get there, and why is that information important?

The dispatchers and call receivers do a great job of getting as much information as possible for us before we arrive. However, people are often under a great deal of stress when they call 911. So the story that is relayed is not always the whole story. So we use the pre-arrival information to start framing a picture in our head of what might be going on, but we also have to keep an open mind – since the situation may have changed since the time when the reporting party called 911.

The information provided by callers to 911 is also important to help dispatchers decide what resources to send — how many units, Advanced vs. Basic Life Support, and any additional specialty units for the given emergency.

How do you stay calm during stressful situations, and keep the people around you calm as well?

Our world-class medic training at Harborview Medical Center with UW Medicine and Seattle Fire Department prepare us very well for most of what we will ever encounter in our careers. Having high-quality training and lots of exposure to a wide variety of medical and trauma patients makes future stressful situations much more easy to handle.

We have a 2-medic crew on every medic unit, so the two can back up each other on difficult calls. There is a fine balance between exhibiting compassion for a patient and staying objectively in control of the situation. Our medics do a great job of this and it is exhibited in the thank you letters we get from grateful patients.

Paramedics need to get to patients fast, and deliver them to the hospital quickly as well. How do you balance safety and speed on the road?

Safety always trumps speed. Excessively fast driving places other people at risk, not to mention the patient and the paramedic crew. Our life-saving interventions do not stop when we start driving the patient to the hospital. So we have to drive carefully since our crew in the back of the medic unit may be delivering medical care to the patient as they go to the hospital. We put all of our paramedics through emergency vehicle driving classes on an on-going basis and we also have them perform quarterly evaluations.

What’s the most interesting/most heartfelt call you’ve been on?

I enjoy calls where I felt like I made a difference. That difference may come from advanced medical intervention, or it might just be from a smile of reassurance or helping someone in their time of need.

What do you do between emergency calls to prepare for the next one?

We have daily, weekly and monthly chores around the fire station. We also have a great deal of on-going medical education to complete. So at any given time, in between alarms, our medics may be cleaning, re-stocking, studying, etc. We also encourage them to take care of themselves and pace themselves for a long 24 hour shift. So they might take time to work out, make a meal or take a nap in between alarms.

What do you like most about your work?

I enjoy the detective work of being a paramedic. I also enjoy to make order out of a chaotic scene.

What can the public do to help?

One important thing you can do is help your elderly loved ones and neighbors. Check on them on very hot and very cold days, and make sure they have a list of medicines and medical conditions handy.